Sousa Francisco, Santos Mariline, Azevedo Sara, Pinto Ana, Vaz Freitas Susana, Coutinho Miguel, Almeida E Sousa Cecília, Moreira da Silva Álvaro
Otolaryngology - Head and Neck Surgery, Centro Hospitalar Universitário do Porto, Porto, PRT.
Intensive Care Unit, Centro Hospitalar Universitário do Porto, Porto, PRT.
Cureus. 2023 Jan 23;15(1):e34078. doi: 10.7759/cureus.34078. eCollection 2023 Jan.
To date, little is known about the long-term predictors of quality of life (QoL) in unilateral vocal fold paralysis (UVFP). The main objective of this study was to evaluate the predictors of long-term QoL in UVFP patients submitted to voice therapy (VT) exclusively. Data from patients diagnosed with UVFP who followed a VT program between 2013 and 2019 were reviewed. Video laryngoscopy (VL) records were obtained at the beginning and at the end of VT. To assess QoL, Voice Handicap Index 30 (VHI-30) score was assessed in three temporal frames: before voice therapy (pre-VT), at the last VT session (post-VT), and in the present (cur-VHI). A longitudinal analysis was performed regarding the evolution of QoL and the factors influencing QoL through time were analyzed. Seventy-eight percent of patients had iatrogenic UVFP. The mean time of follow-up after VT was 3.942 years (range 6 months-7 years). There was a significant improvement in QoL through all time points (F (2,88)=72.179, p<0.001), with VHI-30 decrease from the baseline pre-VT to post-VT(p<0.001) and from post-VT to cur-VT (p=0.0013). In the iatrogenic UVFP population, patients starting VT earlier showed better long-term QoL (p=0.023). UVFP patients with dysphagia at presentation showed significantly worse QoL in the late follow-up (p=0.016). Hence, iatrogenic UVFP patients beginning VT rapidly may show better QoL in the future. Also, our results suggest that dysphagia at UVFP onset may predict higher morbidity later in life.
迄今为止，关于单侧声带麻痹（UVFP）患者生活质量（QoL）的长期预测因素知之甚少。本研究的主要目的是评估仅接受嗓音治疗（VT）的UVFP患者长期生活质量的预测因素。回顾了2013年至2019年间诊断为UVFP并接受VT治疗的患者的数据。在VT开始时和结束时获取视频喉镜（VL）记录。为了评估生活质量，在三个时间点评估嗓音障碍指数30（VHI-30）评分：嗓音治疗前（VT前）、最后一次VT治疗时（VT后）和目前（当前VHI）。对生活质量的演变进行了纵向分析，并分析了随时间影响生活质量的因素。78%的患者患有医源性UVFP。VT后的平均随访时间为3.942年（范围6个月至7年）。在所有时间点，生活质量均有显著改善（F(2,88)=72.179，p<0.001），VHI-30从VT前的基线水平降至VT后（p<0.001），从VT后降至当前VHI（p=0.0013）。在医源性UVFP人群中，更早开始VT的患者长期生活质量更好（p=0.023）。就诊时伴有吞咽困难的UVFP患者在后期随访中生活质量明显更差（p=0.016）。因此，迅速开始VT的医源性UVFP患者未来可能表现出更好的生活质量。此外，我们的结果表明，UVFP发病时的吞咽困难可能预示着晚年更高的发病率。
